Abstract for presentation at 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 2008

This case study highlights the value of ¹¹¹In-Octreotide imaging in the management of recurrent carcinoid tumours. In 2004, a 55 year old man underwent a small bowel and pre-aortic nodal resection for small bowel carcinoid tumour. Initial postoperative ¹¹¹In-Octreotide imaging was negative for tumour recurrence. ¹¹¹In-Octreotide imaging 2 years later showed focal uptake in the root of small bowel mesentery, suspicious for recurrence. However this was in the setting of negative endoscopic ultrasound, ¹⁸F-FDG PET/CT and multiple CT scans of the abdomen and pelvis. A repeat ¹¹¹In-Octreotide scan 7 months later showed persistent abnormality in a similar location. As there was no corresponding structural abnormality detected on anatomical imaging, the lesion was excised under gamma probe guidance. The operative pathology specimen showed 10 lymph node carcinoid metastases. Postoperative and follow-up ¹¹¹In-Octreotide imaging findings were normal. ¹¹¹In-Octreotide imaging in this case proved to be indispensable in detecting and localizing carcinoid recurrence when no other imaging modality was able to do so. It also demonstrated the usefulness of gamma probe-guided surgery for the localisation and removal of ¹¹¹In-Octreotide -avid tumours.